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NPI Code Detail

MEDICARE: SOPHIA CAMPOS

MEDICARE: SOPHIA CAMPOS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2103K00000XBehavior AnalystFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912545591
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIA CAMPOS
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 866-610-0580
Fax Number :
Provider Business Practice Location Address
First Line : 464099 STATE ROAD 200 STE 2
Second Line :
City : YULEE
State : FL
Zip : 32097-6460
Country : US
Telephone Number : 904-875-4461
Fax Number : 904-659-0130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2019
Last Update Date : 11/19/2024

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Directions to “ SOPHIA CAMPOS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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